Enlarged prostate (BPH)
Also called: Benign prostatic hyperplasia, BPH
Non-cancerous growth of the prostate with age, which squeezes the urethra and causes a weak stream and frequent urination.
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Half of men over 50 and most men over 80.
Causes
- Age-related, androgen (DHT)-dependent growth of prostate tissue
Risk factors
- Age
- Family history
- Obesity and diabetes
Symptoms
- Weak or interrupted stream
- Hesitancy
- Frequent urination and waking at night
- Urgency
- Feeling of incomplete emptying
- Dribbling
Diagnosis — tests and examinations
- Symptom score (IPSS)
- Digital rectal examination
- Urine test, PSA after counselling
- Flow rate and bladder scan
Treatment
Medicines and medical treatment
- Alpha-blockers (tamsulosin) relax the prostate
- 5-alpha-reductase inhibitors (finasteride) shrink it over months
- Combination therapy; tadalafil in some
Operations and procedures
- Transurethral resection of the prostate (TURP)
- Holmium laser enucleation (HoLEP)
- Minimally invasive options (Urolift, Rezum)
- Catheter for acute retention
Self-care, home remedies and lifestyle
- Reduce evening fluids, caffeine and alcohol
- Double voiding
- Bladder training
Possible complications
- Acute urinary retention
- Infections and stones
- Bladder damage
Prevention
- None proven
Outlook
Symptoms usually controllable with medicine or surgery.
When to see a doctor
See a doctor for urinary symptoms; urgently if you cannot pass urine.
Sources and further reading
These sources cover this condition. They have not been checked against every statement on this page.
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